Licensed Population Health Specialist

Job Summary

Working remotely on a full-time basis, the Licensed Population Health Specialist will serve as a Quality Specialist in HEDIS abstraction, conduct extensive electronic medical record reviews, and support the implementation of workflows to close care gaps in preventive care and chronic condition management.

Key responsibilities

• Perform HEDIS abstraction and ensure compliance with quality metrics through EHR data validation
• Monitor performance towards organizational quality measure goals and assist in implementing system-wide interventions
• Collaborate with the Mission-Inspired Transformation team on innovations to enhance care delivery for vulnerable populations

Required qualifications

• High School diploma equivalency with 2 years of cumulative experience, OR an Associate's/Bachelor's degree, OR 4 years of applicable job-specific experience
• Clinical license (e.g., RN, LPN) background preferred
• Minimum of 2 years of experience in healthcare quality, population health, or payer-side HEDIS audit/abstraction roles
• Experience with auditing/abstraction of clinical data points from medical records, focusing on HEDIS measures
• Familiarity with value-based care programs (e.g., Medicare Advantage, ACOs) is strongly preferred